MILLIONS of girls around the world undergo the horrors of "female circumcision" – held down by community elders or members of their own family, they are subjected to female genital mutilation (FGM).

Yet, two years after Scotland upgraded the law here against FGM, there has been little training of medical and educational professionals, and even less public debate. Campaigners and the police agree there are girls in Scotland – usually aged between seven and nine, sometimes younger – at risk of being taken out of the UK for a holiday and being subjected to the procedure.

Medical professionals in Scotland are being confronted with the complications and often horrible damage of FGM – both physical and mental. Today, a major two-day conference begins in Glasgow with the aim of finding ways of increasing public awareness of FGM and continuing existing work with the health services on the issue.

Caterina O'Connor, training co-ordinator on gender-based violence at the Greater Glasgow Training Consortium, and one of the organisers of the conference, says: "There's nothing in any religion that says it is necessary. (But] if you live in a community where 98 per cent have experienced FGM, and if you have problems with your periods, abdominal pain, urinating, then you think this is result of being a woman and not of being mutilated. It's not detected through health and FGM is not on the police radar. If you don't know anything about FGM, you will not know what to look for."

Glasgow City Council, the authority with the largest populations originally from countries where FGM is practised, says it has no specific guidelines on FGM but the issue is covered by its general policy on violence against women. A spokeswoman says its first point of contact would Glasgow's Sandyford Initiative sexual health service.

The British Medical Association, the Royal College of Midwives (RCM) and the Royal College of Obstetricians and Gynaecologists all have policy papers on the issue, published online.

Gillian Smith, from the RCM Board for Scotland, says: "Midwife students would have some teaching on this during their training but would probably not see that many. However, with the numbers of women from outside the UK having babies here, it will probably increase.

"There are difficulties for midwives who do not want to lose the trust of the women so that they do not stop seeking the support of the midwives, therefore putting their health and that of the baby at risk. Our own position paper has been around for a number of years which gives individual midwives good guidance and also they get support from their supervisor of midwives."

Dr David Farquharson, a consultant obstetrician and gynaecologist at the Simpson Centre for Reproductive Health at the Edinburgh Royal Infirmary, says: "We do have cases in Scotland but we don't have the same sort of problems as London, where it's a very common problem. We would be reliant on a small group of individuals to give advice on an individual basis."

The Foundation for Women's Health, Research and Development (Forward), an international non-governmental organisation, has compiled figures suggesting that 20,000 girls in the UK are at risk of FGM. Naana Otoo-Oyortey, Forward's director, says some information from hospitals between 2001 and 2004 showed a 40 per cent increase in women who have been subjected to some sort of FGM.

Recent figures from Liverpool maternity services revealed 237 women had been seen with FGM in the past three years, but experts warned these numbers don't reveal the full extent of the problem – for instance, there are no figures for Scotland.

There are four types of FGM outlined by the World Health Organisation, with two types most prevalent in the UK: Type II, which involves the cutting out of the clitoris with partial or total cutting of the labia minora, and Type III, defined as cutting part or all of the external genitalia and stitching or otherwise narrowing the vagina opening, known as infibulation.

London-based midwife Comfort Momoh was made an MBE in the New Year honours list for her work reversing Type III FGM cases. She has trained midwives around the UK and will be speaking at this week's conference in Glasgow. There are now 14 clinics in the UK continuing the work.

Kathleen Marshall, Scotland's Commissioner for Children and Young People, says: "A lot more needs to be done to raise awareness among those who come into contact with girls who might be vulnerable to it. They need to be able to pick up on the significance of things these girls might do or say. They need to know what the law can do to protect them. And the girls who are vulnerable need access to this information too."

A spokesman for the Scottish Government says: "Guidance on the new legislation, how to enforce it and the signs which may indicate that FGM has taken place was issued to all police, social and community, and education workers. We want to eradicate FGM and protect girls in Scotland."

'You are taking away some girl's wish'

AMINA Ahmed, 54, was subjected to female genital mutilation (FGM) when she was just 11, living in Somalia. She's been campaigning against the procedure for the past seven years.

"I WENT through the procedure when I was 11 years old," she explains.

"It's absolutely painful and harmful and does not have any benefit for the woman to have that thing. It takes away their sexual feelings.

"At my age, there was no anaesthetic. I was feeling everything. I was feeling the scissors cutting my labia.

"Six or seven strong women in the community held my legs and arms because I wanted to fight for myself.

"I nearly broke my bones I was struggling so hard. I went to run away.

"It's a very serious thing and very abusive.

"You are taking away some girl's wish, someone who is innocent, someone who has no choice at all."

Ahmed, who now lives in Sheffield, says: "When it happened to me I was proud of myself.